| NPI | 1154682839 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: TX R1582) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: OK 29074) |
| Enumeration Date | 2012-05-30 |
| Last Update Date | 2022-07-21 |